Anthrax, Then and Now (cont.)

The California case--1976

The patient was a 32-year-old artistic weaver who worked
at home. He purchased his yarns from commercial suppliers. Investigations later
revealed that the source of his infection was imported wool from Pakistan. The patient
had been well until he developed a fever and sore throat, six days before his death. The illness
progressed to include chest pain, headache, nausea, and loss of appetite. During the illness, his
major difficulties were trouble breathing, mental problems such as an inability
to carry out simple commands, and involuntary eye and limb movements.

A spinal tap
(removal of some spinal fluid for analysis) revealed spinal fluid bacteria that
looked very much like anthrax. All of these findings indicated involvement of
the lungs and central nervous system (spinal cord
and brain). The bacterial organism was eventually confirmed at the CDC to be anthrax. In spite of antibiotic therapy, the patient
died. In this case, the antibiotics were begun late in the course of the
disease, after the anthrax had spread throughout the body.

Several medical examiner's offices and university hospitals in California
declined to do the autopsy, presumably for fear of contracting or spreading the
anthrax infection. When the UCLA Department of Pathology was asked to perform
the autopsy, the faculty agreed for several reasons:

As part of a teaching and research institution, they
felt obligated to society to do the autopsy.

They had the appropriate facilities, namely, an
isolation room to limit exposure.

They had experts in the pathology of infectious
diseases and neuropathology on the faculty.

For forewarned and prepared pathologists, the risk of getting infected
during the autopsy was actually quite small.

The deceased was transported to UCLA in a sealed plastic body bag within a
sealed metal container. The major findings at the autopsy were heavy lungs that
were congested with blood and fluid, as well as bleeding into the central chest
cavity (mediastinum) and the surface (meninges) of the brain (see Figure I below).
These findings are characteristic of patients who die of anthrax. Finally,
scientists from the CDC flew out to California to collect specimens and
confirmed that the victim died of anthrax.